NIPPV与HFNC交替疗法对重症肺炎致呼吸衰竭患者动脉血气指标及炎症因子水平的影响

Effects of NIPPV and HFNC alternating therapy on arterial blood gas indexes and inflammatory factors levels in patients with respiratory failure caused by severe pneumonia

目的研究无创正压通气(NIPPV)与经鼻高流量湿化氧疗(HFNC)交替疗法对重症肺炎致呼吸衰竭患者动脉血气指标及炎症因子水平的影响。方法选取我院2021年4月至2022年4月收治的80例重症肺炎致呼吸衰竭患者为研究对象,根据治疗方法将其分为对照组(n=40)和观察组(n=40)。对照组行单一NIPPV治疗,观察组采用NIPPV与HFNC交替疗法。比较两组的治疗效果。结果治疗2 h后,两组的呼吸频率(RR)、心率(HR)及平均动脉压(MAP)均低于治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗2 h后,观察组的动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))高于对照组,差异具有统计学意义(P<0.05);治疗2 h后,两组的动脉血二氧化碳分压(PaCO_(2))比较,差异无统计学意义(P>0.05)。治疗1 d后,两组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平低于治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。结论NIPPV与HFNC交替疗法在重症肺炎致呼吸衰竭患者急救中的应用效果显著,可改善血流动力学,提升血氧指标,减轻炎症反应。

Objective To study the effects of non-invasive positive pressure ventilation(NIPPV)and humidified high flow nasal cannula oxygen therapy(HFNC)alternating therapy on arterial blood gas indexes and inflammatory factors levels in patients with respiratory failure caused by severe pneumonia.Methods Eighty patients with respiratory failure caused by severe pneumonia admitted in our hospital from April 2021 to April 2022 were selected as the study objects and divided into control group(n=40)and observation group(n=40)according to treatment methods.The control group was treated with single NIPPV,and the observation group was treated with NIPPV and HFNC alternating therapy.The therapeutic effects of the two groups were compared.Results After 2 h of treatment,respiration rate(RR),heart rate(HR)and mean arterial pressure(MAP)in both groups were lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).After 2 h of treatment,arterial oxygen saturation(SaO_(2))and arterial partial pressure of oxygen(PaO_(2))in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05);after 2 h of treatment,there was no significant difference in arterial partial pressure of carbon dioxide(PaCO_(2))between the two groups(P>0.05).After 1 d of treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein(hs-CRP)in two groups were lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).Conclusion The NIPPV and HFNC alternating therapy applied in the emergency treatment of patients with respiratory failure caused by severe pneumonia has remarkable effect,which can improve hemodynamics,increase blood oxygen indexes,and reduce inflammatory response.